ArticleClinical journal of the American Society of Nephrology : CJASN2013
Extracorporeal therapy for dabigatran removal in the treatment of acute bleeding: a single center experience.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 101 citations in OpenAlex.
- The Reversal of Bleeding Caused by New Oral Anticoagulants (NOACs): A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2018Pooled it
- Use of Direct Anticoagulants in Kidney Transplant Recipients: Review of the Current Evidence and Emerging Perspectives.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025Review
- Edoxaban pharmacokinetics during in vitro continuous renal replacement therapy.BMC nephrology · 2024Article
- Coagulation Tests and Reversal Agents in Patients Treated with Oral Anticoagulants: The Challenging Scenarios of Life-Threatening Bleeding and Unplanned Invasive Procedures.Journal of clinical medicine · 2024Review
- Dabigatran overload in acute kidney injury: haemodialysis or idarucizumab? A case report and proposal for a decisional algorithm.Clinical kidney journal · 2021Article
- Use of direct oral anticoagulants in ICU patients. Part II - Clinical evidence.Anaesthesiology intensive therapy · 2021Review
- Use of direct oral anticoagulants in ICU patients. Part I - Applied pharmacology.Anaesthesiology intensive therapy · 2021Review
- Novel reversal agents and laboratory evaluation for direct-acting oral anticoagulants (DOAC): An update.Indian journal of anaesthesia · 2019Review
- Management of antithrombotic agents in patients undergoing flexible bronchoscopy.European respiratory review : an official journal of the European Respiratory Society · 2017Review
- Dabigatran overdose: a case report of acute hepatitis. Extracorporeal treatment.International journal of hematology · 2017Article
- Direct oral anticoagulant considerations in solid organ transplantation: A review.Clinical transplantation · 2017Review
- A case of tumor lysis syndrome and acute renal failure associated with elotuzumab treatment in multiple myeloma.Clinical nephrology. Case studies · 2017Article
- Management of antithrombotic therapy during cardiac implantable device surgery.Journal of arrhythmia · 2016Review
- Who, when, and how to reverse non-vitamin K oral anticoagulants.Journal of thrombosis and thrombolysis · 2016Review
- Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage: A Statement for Healthcare Professionals from the Neurocritical Care Society and Society of Critical Care Medicine.Neurocritical care · 2016Review
- Use of Continuous Renal Replacement Therapy for Removal of Dabigatran in a Patient in Need of Emergent Surgery.Case reports in critical care · 2016Article
- Dabigatran-Associated Intracranial Hemorrhage: Literature Review and Institutional Experience.The Neurohospitalist · 2015Review
- Venovenous haemodiafiltration for the management of dabigatran overdose in intensive care unit.Clinical kidney journal · 2015Article
- Enhanced elimination of dabigatran through extracorporeal methods.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2015Review
- Hemostatic management of patients undergoing ear-nose-throat surgery.GMS current topics in otorhinolaryngology, head and neck surgery · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesDabigatran is an oral direct thrombin inhibitor that is Food and Drug Administration-approved for prevention of stroke in patients with atrial fibrillation. No antidote is available for reversal of dabigatran's anticoagulant effect. Despite limited clinical data, hemodialysis has been suggested as a strategy to remove dabigatran during acute bleeding. This work presents five cases, in which extracorporeal therapy was performed for dabigatran removal in acutely bleeding patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The series is comprised of five consecutive cases of patients receiving dabigatran 150 mg per os two times daily who were admitted with life-threatening bleeding between March of 2012 and January of 2013. Dabigatran plasma concentrations ranged from 149 to 1200 ng/ml. Treatment included administration of blood products to all patients and then, high-flux intermittent hemodialysis alone or followed by continuous renal replacement therapy.
resultsDabigatran concentrations decreased by 52%-77% during intermittent hemodialysis but rebounded up to 87% within 2 hours after completion of dialysis. Initiation of continuous renal replacement therapy after intermittent hemodialysis attenuated the rebound effect in one patient and contributed to a reduction in dabigatran concentrations of 81% over 30 hours.
conclusionsExtracorporeal therapy lowered dabigatran concentrations, suggesting that it removed the drug and may effectively accelerate total clearance, especially in patients with impaired kidney function. The use of prolonged intermittent hemodialysis or intermittent hemodialysis followed by continuous renal replacement therapy is recommended for the management of life-threatening bleeding in patients receiving dabigatran. The advantage of extracorporeal therapy should be weighed against the risk of bleeding with catheter insertion.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.